Cultural Diversity in Health & Illness / Edition 6

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Overview

The sixth edition of this best-selling resource continues to teach nursing, health professions, medical and social science readers the importance of cultural competence and cultural awareness in the health care industry. The new edition will include revised organization to create a better flow of content, new content on gererational differences, updated chapter on health care delivery system, updated illustrations and tables and MediaLink icons. For undergraduate and graduate courses in patient care and basic health related profession programs, as well as medical, social work, and other health disciplines.

The book contains black-and-white illustrations.

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Editorial Reviews

From The Critics
Reviewer: Vicki Ann Moss, DNSc, MS, BSN, RN (University of Wisconsin-Oshkosh)
Description: This is the 6th edition of a book that covers foundations for building cultural competence, a discussion of diversity in North America, and chapters on selected population groups — American Indian and Alaska Native, Asian, Black, Hispanic, and White. In addition, it discusses many health and healing traditions, including the role of faith in healing, and examines the current issues of healthcare delivery. Included are numerous figures and tables that augment the narrative material. This book was first published in 1977 and the previous edition was published in 2000.
Purpose: "The purpose of this book is to promote "awareness of the dimensions and complexities involved in caring for people from diverse cultural backgrounds" (p. xi). It is useful in fulfilling the requirement of the recent policy of the Joint Commission on Accreditation of Healthcare Organizations and the Centers for Medicare and Medicaid Services that all health providers be culturally competent. "
Audience: "This book is appropriate for any student in the allied health professions, nursing, medicine, social work, and others. It can also be a useful companion for those in community health, long term care, and chronic care areas. The author has 30 years of experience studying culture, ethnicity, and religion and their influence on health, illness, and healing. "
Features: "This book features a free companion Web site with activities, multiple-choice questions and more. Students get instant feedback after submission of quiz questions and can have them routed to the instructor via e-mail. There are also links to the New York Times and USA Today's Census 2000. Online companions for schools using course management systems are also available. The eight appendixes include a suggested course outline and course activities, a Heritage Assessment Tool, and a Quick Guide for Cultural Care. Resources including Web sites that enhance knowledge of cultural care are also provided. Unique features of this book are health images or symbols which appear at the beginning of each chapter and link information from one chapter to the next. A free pocket guide to Assessment and Health Tradition is also available. "
Assessment: This book and companion Web site are an instructor's dream, since they contain numerous resources and many teaching and learning strategies. One chapter explores the provider's perception of health and illness that is necessary in order to develop sensitivity and an understanding of other cultural groups' health, illness, and healing practices. There is an updated chapter on the healthcare delivery system and discussions of the influences of recent social, political, and demographic changes that are shaping healthcare. It is an easy read with practical suggestions for developing cultural competence. The many images, symbols, and pictures bring the reader into a more personal and intimate connection with the narrative and the cultural practices discussed.
Joan C. Murphy
This fifth edition, well-known, cultural work continues to deepen and expand the reader's theory and sense of inquiry. The purpose, as in past editions, is to increase the reader's awareness of the "dimensions and complexities involved as we meet the health and illness needs of patients." Cultural competence is now mandated by the Joint Commission of Hospital Accreditation and the Health Care Financing Administration. The author uses the notion of a quilt as a theme, thereby imaging continuity from chapter to chapter. This book is intended for virtually anyone providing healthcare, but especially nurses and nursing students as we are constantly encountering cultural diversity. The author is successful in this effort. The twelve chapters are divided into three units. In the first the focus is on provider self-awareness, in the second cultural awareness, and in the third selected traditional views of health and illness. One example is Chapter 11, "Health and Illness in Hispanic America." There are eight very valuable appendixes including Suggested Course Outline and Suggested Course Activities. There is an extensive (20 page) bibliography and an impressive directory of alternative healthcare associations. As discussed by the author, the U.S. will continue to receive a significant portion of its population via immigration. Given that prediction, it is imperative that educators and those already in practice focus on initial and ongoing cultural competency. This evolving theory base has become obligatory for humane, ethical, and legal practice. Ongoing cultural shifts and new theory necessitate the new edition.
Booknews
Written by a nurse, primarily for nurses, summarizes issues of provider self-awareness and delivery and acceptance of health care, and traditional views of health and illness in the context of various American ethnic groups. The bibliographies for each section are extensive. Annotation c. Book News, Inc., Portland, OR (booknews.com)

5 Stars! from Doody
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Product Details

  • ISBN-13: 9780130493798
  • Publisher: Prentice Hall
  • Publication date: 7/23/2003
  • Edition description: REV
  • Edition number: 6
  • Pages: 400
  • Product dimensions: 5.94 (w) x 8.96 (h) x 0.82 (d)

Meet the Author

Table of Contents

Preface
Acknowledgments
Ch. 1 Health Care 2000 - Meeting the Needs of a Multicultural Society 3
Ch. 2 Health and Illness 19
Ch. 3 Familial Folk Remedies 45
Ch. 4 Culture, Health, and Illness 63
Ch. 5 Health Care Delivery: Issues, Barriers, and Alternatives 93
Ch. 6 Healing: Natural Traditions 117
Ch. 7 Healing: Magicoreligious Traditions 133
Ch. 8 The Influence of Demographics on Health Care 169
Ch. 9 Health and Illness in African (Black) American Communities 191
Ch. 10 Health and Illness in the American Indian, Aleut, and Eskimo Communities 215
Ch. 11 Health and Illness in the Asian/Pacific Islander American Community 241
Ch. 12 Health and Illness in European (White) American Communities 261
Ch. 13 Health and Illness in Hispanic American Communities 279
Ch. 14 The Use of Parteras in the Rio Grande Valley, Texas 305
Epilogue 331
Bibliography 339
Appendix I: Selected Key Terms Related to Cultural Diversity in Health and Illness 357
Appendix II: Suggested Course Outline 365
Appendix III: Suggested Course Activities 369
Appendix IV: Heritage Assessment Tool 371
Appendix V: Quick Guide for Cross-Cultural Nursing Care 375
Appendix VI: Data Resources 377
Appendix VII: NIH Office of Alternative Medicine 379
Appendix VIII: Networks: Selected Health-Related Organizations 387
African (Black) American 387
American Indian, Aleut, and Eskimo 388
Asian/Pacific Islander 389
Hispanic American 391
Multicultural 392
Index 395
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Preface

You don't need a masterpiece to get the idea.
– Pablo Picasso

In 1977 I wrote the first edition of Cultural Diversity in Health and Illness and have revised it several times since then; this is the sixth edition. The purpose of each edition has been to increase the reader's awareness of the dimensions and complexities involved in caring for people from diverse cultural backgrounds. I wished to share my personal experiences and thoughts concerning the introduction of cultural concepts into the education of health care professionals. The books represented my answers to the questions:

  • "How does one effectively expose a student to cultural diversity?"
  • "How does one examine health care issues and perceptions from a broad social viewpoint?"

As I had done in the classroom, I attempted to bring the reader into direct contact with the interaction between providers of care within the North American health care system and the consumers of health care. The staggering issues of health care delivery are explored and contrasted with the choices that people may make in attempting to deal with health care issues.

It is now imperative, according to the most recent policies of the Joint Commission of Hospital Accreditation and the Centers for Medicare & Medicaid Services, that all health care providers be culturally competent. In this context, cultural competence implies that within the delivery of care the health care provider understands and attends to the total context of the patient's situation; it is a complex combination of knowledge, attitudes, and skills. Yet,

  • How do you really inspirepeople to hear the content?
  • How do you motivate providers to see the worldview and lived experience of the patient? How do you assist providers to really bear witness to the living conditions and life ways of patients?
  • How do you liberate providers from the burdens of prejudice, xenophobia, the "isms"—racism, ethnocentrism—and the "antis"?

It can be argued that the development of cultural competency does not occur in a short encounter with cultural diversity; but that it takes time to develop the skills, knowledge, and attitudes to safely and satisfactorily deliver CulturalCare.

Features
  • Free Companion Web site at www.prenhall.com/spector with activities, fill-in-the-blanks, multiple choice questions, web links, and more.
  • Online Course Management Systems. Also available are online companions for schools using course management systems. For more information about adopting an online course management system to accompany Cultural Diversity in Health and Illness, Sixth Edition please contact your Prentice Hall Health Sales Representative www.prenhall.com/mischtm/rep-locator-fr.html or go to the appropriate websites at cms.prenhall.com/webct/index.html or cms.prenhall.com/blackboard/index.html or cms.prenhall.com/coursecompass
  • Health Traditions Imagery. This edition of the book uses symbolic images to create the linkages from chapter to chapter. The HEALTH (HEALTH, when written this way, is defined as the balance of the person, both within one's being-physical, mental, spiritual-and in the outside world-natural, familial and communal, metaphysical) images were selected to awaken you to the richness of a given heritage and the HEALTH/health beliefs, and practices inherent within both modern and traditional cultures.
  • Guidelines for Developing Cultural Competency. A "map" that passes from broad and general dimensions of health and illness to specific images of traditional HEALTH beliefs and practices; at the personal level, the modern health care delivery level, and within traditional dimensions.
  • Three developmental dimensions:
    1. Cultural Foundations—an overview of cultural heritage and history that serves to illustrate the underlying concepts inherent in the diversity within our society, and basic elements of health and illness.
    2. Domains of HEALTH—the worlds of the provider and patient as reflected in broad and general HEALTH and HEALING from a personal perspective to the perspectives of socialization into the allopathic philosophy and health care delivery system.
    3. Panoramas of HEALTH—the worlds of traditional HEALTH beliefs and practices among selected populations.
  • Historical Perspectives. An overview of historic sociocultural, public health, and health policy events and medical milestones from 1900 to 2003.
OVERVIEW

Unit I focuses on the background knowledge one must recognize as the foundation for developing cultural competency.

  • Chapter 1 explores the concept of cultural heritage and history and the roles they play in one's perception of health and illness. This exploration is first outlined in general terms: What is culture? How is it transmitted? What is ethnicity? What is religion? How do they affect a given person's health? What major sociocultural events occurred during the life trajectory of a given person that may influence their personal health beliefs and practices?
  • Chapter 2 presents a discussion of the diversity—demographic, immigration, and poverty—that impacts on the delivery of and access to health care. The backgrounds of each of the U.S. Census Bureau's categories of the population, an overview of immigration, and an overview of issues relevant to poverty are presented.
  • Chapter 3 reviews the provider's knowledge of his or her own perceptions, needs, and understanding of health and illness.

Unit II explores the domains of HEALTH, blends them with one's personal heritage, and contrasts them with allopathic philosophy.

  • Chapter 4 introduces the concept of HEALTH and develops the concept in broad and general terms. The HEALTH Traditions Model is presented, as are natural methods of HEALTH restoration.
  • Chapter 5 explores the concept of HEALING and the role that faith plays in the context of HEALING, or magico-religious, traditions. This is an increasingly important issue, which is evolving to a point where the health care provider must have some understanding of this phenomenon.
  • Chapter 6 discusses family heritage and explores personal and familial HEALTH traditions. It includes an array of familial health beliefs and practices shared by people from many different heritages.
  • Chapter 7 focuses on the allopathic health care delivery system and the health care provider culture.

Once the study of each of these components has been completed, Unit III moves on to explore selected population groups in more detail, to portray a panorama of traditional HEALTH and ILLNESS beliefs and practices, and present relevant health care issues.

These pages can neither do full justice to the richness of any one culture nor any one health-belief system. By presenting some of the beliefs and practices and suggesting background reading, however, the book can begin to inform and sensitize the reader to the needs of a given group of people. It can also serve as a model as to how to develop cultural knowledge in populations that are not included.

The Epilogue is devoted to an overall analysis of the book's contents and how best to apply this knowledge in health care delivery, health planning, and health education, for both the patient and the health care professional.

There is so much to be learned. Countless books and articles have now appeared that address these problems and issues. It is not easy to alter attitudes and beliefs or stereotypes and prejudices. Some social psychologists state that it is almost impossible to lose all of one's prejudices, yet alterations can be made. I believe the health care provider must develop the ability to deliver CulturalCare and a sensitivity to personal fundamental values regarding health and illness. With acceptance of one's own values comes the framework and courage to accept the existence of differing values. This process of realization and acceptance can enable the health care provider to be instrumental in meeting the needs of the consumer in a collaborative, safe, and professional manner.

The first edition of this book was the outcome of a promesa—a promise—once made. The promise was made to a group of Black and Hispanic students I taught in a medical sociology course in 1973. In this course, the students wound up being the teachers, and they taught me to see the world of health care delivery through the eyes of the health care consumer rather than through my own well-intentioned eyes. What I came to see I did not always like. I did not realize how much I did not know; I believed I knew a lot. I have held on to the promesa, and my experiences over the years have been incredible. I have met people and traveled. At all times I have held on to the idea and goal of attempting to help nurses and other providers be aware of and sensitive to the beliefs and needs of their patients.

I know that looking inside closed doors carries with it a risk. I know that people prefer to think that our society is a melting pot and that old beliefs and practices have vanished with an expected assimilation into mainstream North American life. Many people, however, have continued to carry on the traditional customs and culture from their native lands, and health and illness beliefs are deeply entwined within the cultural and social beliefs that people have. To understand health and illness beliefs and practices, it is necessary to see each person in his or her unique sociocultural world.

The shattering events of September 11, 2001, represent in many ways the clarion call for all of us to wake up and hear and listen to the voices of all people. Indeed, the events are symptomatic of Global Polarization in such conflicts as:

  • Traditionalism vs. Modernism
  • Fundamentalism vs. Universalism
  • Heritage vs. Secular
  • Minimalism vs. Excessism
  • Self-Denialism vs. Materialism
  • Fatalism vs. Determinism
  • Allopathy vs. Homeopathy
  • Curing vs. HEALING

Global Polarization is culturally based and seems to be the engine driving recent events. It is an attempt to look at the big picture that encompasses health care and attempts to find cultural meaning in daily life. In our world, that of health care delivery, it mandates that we must develop the knowledge and skills of CulturalCare.

This book is written primarily for the student in basic allied health professional programs, nursing, medical, social work, and other health care provider disciplines. I believe it will be helpful also for providers in all areas of practice, especially community health, long-term oncology, chronic care settings, and geriatric and hospice centers. I am attempting to write in a direct manner and to use language that is understandable by all. The material is sensitive, yet I believe that it is presented in a sensitive manner. At no point is my intent to create a vehicle for stereotyping. I know that one person will read this book and nod "Yes, this is how I see it," and someone else of the same background will say "No, this is not correct." This is the way it is meant to be. It is incomplete by intent. It is written in the spirit of open inquiry, so that an issue may be raised and so that clarification of any given point will be sought from the patient as health care is provided. The deeper I travel into this world of cultural diversity, the more I wonder at the variety. It is wonderfully exciting. By gaining insight into the traditional attitudes that people have toward health and health care, I find my own nursing practice is enhanced, and I am better able to understand the needs of patients and their families. It is thrilling to be able to meet, to know, and to provide care to people from all over the world. It is the excitement of nursing. As we now go forward in time, I hope that these words will help you, the reader, develop CulturalCare skills and help you to provide the best care to all.

Read More Show Less

Introduction

You don't need a masterpiece to get the idea.
– Pablo Picasso

In 1977 I wrote the first edition of Cultural Diversity in Health and Illness and have revised it several times since then; this is the sixth edition. The purpose of each edition has been to increase the reader's awareness of the dimensions and complexities involved in caring for people from diverse cultural backgrounds. I wished to share my personal experiences and thoughts concerning the introduction of cultural concepts into the education of health care professionals. The books represented my answers to the questions:

  • "How does one effectively expose a student to cultural diversity?"
  • "How does one examine health care issues and perceptions from a broad social viewpoint?"

As I had done in the classroom, I attempted to bring the reader into direct contact with the interaction between providers of care within the North American health care system and the consumers of health care. The staggering issues of health care delivery are explored and contrasted with the choices that people may make in attempting to deal with health care issues.

It is now imperative, according to the most recent policies of the Joint Commission of Hospital Accreditation and the Centers for Medicare & Medicaid Services, that all health care providers be culturally competent. In this context, cultural competence implies that within the delivery of care the health care provider understands and attends to the total context of the patient's situation; it is a complex combination of knowledge, attitudes, and skills. Yet,

  • How do you really inspirepeople to hear the content?
  • How do you motivate providers to see the worldview and lived experience of the patient? How do you assist providers to really bear witness to the living conditions and life ways of patients?
  • How do you liberate providers from the burdens of prejudice, xenophobia, the "isms"—racism, ethnocentrism—and the "antis"?

It can be argued that the development of cultural competency does not occur in a short encounter with cultural diversity; but that it takes time to develop the skills, knowledge, and attitudes to safely and satisfactorily deliver CulturalCare.

Features

  • Free Companion Web site with activities, fill-in-the-blanks, multiple choice questions, web links, and more.
  • Online Course Management Systems. Also available are online companions for schools using course management systems. For more information about adopting an online course management system to accompany Cultural Diversity in Health and Illness, Sixth Edition please contact your Prentice Hall Health Sales Representative www.prenhall.com/mischtm/rep-locator-fr.html or go to the appropriate websites at cms.prenhall.com/webct/index.html or cms.prenhall.com/blackboard/index.html or cms.prenhall.com/coursecompass
  • Health Traditions Imagery. This edition of the book uses symbolic images to create the linkages from chapter to chapter. The HEALTH (HEALTH, when written this way, is defined as the balance of the person, both within one's being-physical, mental, spiritual-and in the outside world-natural, familial and communal, metaphysical) images were selected to awaken you to the richness of a given heritage and the HEALTH/health beliefs, and practices inherent within both modern and traditional cultures.
  • Guidelines for Developing Cultural Competency. A "map" that passes from broad and general dimensions of health and illness to specific images of traditional HEALTH beliefs and practices; at the personal level, the modern health care delivery level, and within traditional dimensions.
  • Three developmental dimensions:
    1. Cultural Foundations—an overview of cultural heritage and history that serves to illustrate the underlying concepts inherent in the diversity within our society, and basic elements of health and illness.
    2. Domains of HEALTH—the worlds of the provider and patient as reflected in broad and general HEALTH and HEALING from a personal perspective to the perspectives of socialization into the allopathic philosophy and health care delivery system.
    3. Panoramas of HEALTH—the worlds of traditional HEALTH beliefs and practices among selected populations.
  • Historical Perspectives. An overview of historic sociocultural, public health, and health policy events and medical milestones from 1900 to 2003.

OVERVIEW

Unit I focuses on the background knowledge one must recognize as the foundation for developing cultural competency.

  • Chapter 1 explores the concept of cultural heritage and history and the roles they play in one's perception of health and illness. This exploration is first outlined in general terms: What is culture? How is it transmitted? What is ethnicity? What is religion? How do they affect a given person's health? What major sociocultural events occurred during the life trajectory of a given person that may influence their personal health beliefs and practices?
  • Chapter 2 presents a discussion of the diversity—demographic, immigration, and poverty—that impacts on the delivery of and access to health care. The backgrounds of each of the U.S. Census Bureau's categories of the population, an overview of immigration, and an overview of issues relevant to poverty are presented.
  • Chapter 3 reviews the provider's knowledge of his or her own perceptions, needs, and understanding of health and illness.

Unit II explores the domains of HEALTH, blends them with one's personal heritage, and contrasts them with allopathic philosophy.

  • Chapter 4 introduces the concept of HEALTH and develops the concept in broad and general terms. The HEALTH Traditions Model is presented, as are natural methods of HEALTH restoration.
  • Chapter 5 explores the concept of HEALING and the role that faith plays in the context of HEALING, or magico-religious, traditions. This is an increasingly important issue, which is evolving to a point where the health care provider must have some understanding of this phenomenon.
  • Chapter 6 discusses family heritage and explores personal and familial HEALTH traditions. It includes an array of familial health beliefs and practices shared by people from many different heritages.
  • Chapter 7 focuses on the allopathic health care delivery system and the health care provider culture.

Once the study of each of these components has been completed, Unit III moves on to explore selected population groups in more detail, to portray a panorama of traditional HEALTH and ILLNESS beliefs and practices, and present relevant health care issues.

These pages can neither do full justice to the richness of any one culture nor any one health-belief system. By presenting some of the beliefs and practices and suggesting background reading, however, the book can begin to inform and sensitize the reader to the needs of a given group of people. It can also serve as a model as to how to develop cultural knowledge in populations that are not included.

The Epilogue is devoted to an overall analysis of the book's contents and how best to apply this knowledge in health care delivery, health planning, and health education, for both the patient and the health care professional.

There is so much to be learned. Countless books and articles have now appeared that address these problems and issues. It is not easy to alter attitudes and beliefs or stereotypes and prejudices. Some social psychologists state that it is almost impossible to lose all of one's prejudices, yet alterations can be made. I believe the health care provider must develop the ability to deliver CulturalCare and a sensitivity to personal fundamental values regarding health and illness. With acceptance of one's own values comes the framework and courage to accept the existence of differing values. This process of realization and acceptance can enable the health care provider to be instrumental in meeting the needs of the consumer in a collaborative, safe, and professional manner.

The first edition of this book was the outcome of a promesa—a promise—once made. The promise was made to a group of Black and Hispanic students I taught in a medical sociology course in 1973. In this course, the students wound up being the teachers, and they taught me to see the world of health care delivery through the eyes of the health care consumer rather than through my own well-intentioned eyes. What I came to see I did not always like. I did not realize how much I did not know; I believed I knew a lot. I have held on to the promesa, and my experiences over the years have been incredible. I have met people and traveled. At all times I have held on to the idea and goal of attempting to help nurses and other providers be aware of and sensitive to the beliefs and needs of their patients.

I know that looking inside closed doors carries with it a risk. I know that people prefer to think that our society is a melting pot and that old beliefs and practices have vanished with an expected assimilation into mainstream North American life. Many people, however, have continued to carry on the traditional customs and culture from their native lands, and health and illness beliefs are deeply entwined within the cultural and social beliefs that people have. To understand health and illness beliefs and practices, it is necessary to see each person in his or her unique sociocultural world.

The shattering events of September 11, 2001, represent in many ways the clarion call for all of us to wake up and hear and listen to the voices of all people. Indeed, the events are symptomatic of Global Polarization in such conflicts as:

  • Traditionalism vs. Modernism
  • Fundamentalism vs. Universalism
  • Heritage vs. Secular
  • Minimalism vs. Excessism
  • Self-Denialism vs. Materialism
  • Fatalism vs. Determinism
  • Allopathy vs. Homeopathy
  • Curing vs. HEALING

Global Polarization is culturally based and seems to be the engine driving recent events. It is an attempt to look at the big picture that encompasses health care and attempts to find cultural meaning in daily life. In our world, that of health care delivery, it mandates that we must develop the knowledge and skills of CulturalCare.

This book is written primarily for the student in basic allied health professional programs, nursing, medical, social work, and other health care provider disciplines. I believe it will be helpful also for providers in all areas of practice, especially community health, long-term oncology, chronic care settings, and geriatric and hospice centers. I am attempting to write in a direct manner and to use language that is understandable by all. The material is sensitive, yet I believe that it is presented in a sensitive manner. At no point is my intent to create a vehicle for stereotyping. I know that one person will read this book and nod "Yes, this is how I see it," and someone else of the same background will say "No, this is not correct." This is the way it is meant to be. It is incomplete by intent. It is written in the spirit of open inquiry, so that an issue may be raised and so that clarification of any given point will be sought from the patient as health care is provided. The deeper I travel into this world of cultural diversity, the more I wonder at the variety. It is wonderfully exciting. By gaining insight into the traditional attitudes that people have toward health and health care, I find my own nursing practice is enhanced, and I am better able to understand the needs of patients and their families. It is thrilling to be able to meet, to know, and to provide care to people from all over the world. It is the excitement of nursing. As we now go forward in time, I hope that these words will help you, the reader, develop CulturalCare skills and help you to provide the best care to all.

Read More Show Less

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